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HOOK-SUPERX, L.L.C.
CHC26567-00 MERIDIAN SERVICES CORP
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Covered Entity Details
Entity Name
MERIDIAN SERVICES CORP
Subdivision Name
Meridian Health Services
Type
HRSA-Funded Health Center
340B ID
CHC26567-00
Entity Address
240 N Tillotson Ave
Muncie, IN 47304-3988
Grant Number
H80CS26567
Participating Start Date
4/1/2016
Last Recertification Date
2/20/2025
Pharmacy Details
Pharmacy Name
HOOK-SUPERX, L.L.C.
Pharmacy Address
DBA: CVS/PHARMACY # 06616
425 E MEMORIAL DR
MUNCIE, IN 47302
Pharmacy Comments
Contract Details
Approval Date
1/13/2017
Contract Begin Date
4/1/2017
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Amelia Clark, VP Community Health
(765) 254-5102
Contract Pharmacy Representative
CVS Health
Christian J Reid, 340B Program Director
(401) 374-9782
Signed By Date
1/13/2017
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